EXERCISES FOR ADHESIVE CAPSULITIS

Stretching and Strengthening Exercises for Adhesive Capsulitis

Adhesive capsulitis, commonly known as frozen shoulder, is a progressive condition that presents with pain, stiffness, and markedly limited shoulder mobility(see article on adhesive capsulitis). Its origin may be idiopathic or secondary to trauma, surgery, or prolonged periods of immobilization. Although its natural progression tends toward recovery, this process can extend for months or even years, significantly affecting the patient's quality of life.
Conservative treatment is the foundation of management, and within this, therapeutic exercises play a fundamental role in all stages of the disease. The objective of this guide is to offer a structured and progressive approach to support patient rehabilitation, respecting the clinical stages of capsulitis:

• Stage 1 (Acute pain): Prioritizing pain and inflammation reduction, avoiding aggressive exercises.
• Stage 2 (Progressive stiffness): Beginning with gentle movements, aiming to maintain and regain joint range of motion.
• Stage 3 (Frozen shoulder): Stretching exercises are intensified, and activities are incorporated to improve functional mobility.
• Stage 4 (Thaw): Active work is done to regain full range of motion and strengthen muscles.

It is important to understand that physical therapy should not cause severe pain, although some discomfort during stretching is normal. Consistency and proper progression are key to achieving results.
The following section includes a selection of specific, safe, and effective exercises, which should be adapted to each patient's degree of involvement and clinical stage. The gradual integration of these routines into daily life will decisively contribute to the functional recovery of the shoulder.

Standing Posterior Capsular Stretch:

Standing. Place the assisting hand on the elbow. Bring the elbow toward the shoulder of the assisting arm until you feel a tightness.

When beginning stretches, it is crucial to avoid pain. You should stretch only until you feel tension in the muscle and tendons, and then hold that position for a while until the tension decreases. With practice, you can extend the holding time, but you should never feel pain.

Goals:

• Relieves tension in the posterior capsule and external rotators.
• Improves joint balance in internal rotation.
• Improves joint balance and shoulder stability.

Internal Rotation Towel Stretch:

Standing. Place a towel over your back. The healthy hand provides traction, while the hand on the shoulder you're rehabbing grips the towel without resistance. Pull until you feel tightness.

When starting stretches, it's crucial to avoid pain. You should stretch only until you feel tension in the muscle and tendons, and then hold that position for a while until the tension decreases. With practice, you can extend the length of the stretch, but you should never feel pain.

Goals:

• Improve posterior capsule tension.
• Improve internal rotation.
• Relieve and prevent shoulder pain.

Lying Posterior Capsule Stretch:

Lying on your side on the shoulder you are rehabilitating. Back straight. Scapula locked. With your elbow flexed at 90°, your assisting hand pushes your arm forward, trying to touch the table or floor.

When starting the stretches, it is crucial to avoid pain. You should stretch only until you feel tension in the muscle and tendons, and then hold that position for a while until the tension decreases. With practice, you can extend the holding time, but you should never feel pain.

Goals:

• Relieves tension in the posterior capsule and external rotators.
• Improves joint balance during internal rotation.
• Improves joint balance and shoulder stability.

Pendulum exercise:

Standing or sitting in a chair, lean forward, letting your arm drop without exerting any force, so that it is perpendicular to the floor. Using your body's inertia, perform circular movements clockwise, counterclockwise, forward and backward, and to both sides. Perform 20 repetitions of each movement.

Perform:

• 20 repetitions
• 1 set

Goals:

• Relieve shoulder pain.
• Relax the surrounding muscles: shoulder, cervical, and scapular.
• Reduces shoulder stiffness and improves shoulder joint balance.

Self-Assisted Shoulder Flexion Exercise:

Standing or sitting. With the help of the hand of your contralateral arm, slowly move your arm forward and upward without bending your elbow. Hold for 3 seconds.

Perform:

• 10 repetitions
• 1 set

Goals:

• Shoulder pain relief.
• Reduces shoulder stiffness and improves shoulder joint balance.
• Prevents loss of mobility.

Elastic Band Rowing Exercise:

Stand facing a door or a structure that allows you to attach the resistance band. Grasp the ends with your hands. Keep your back straight. Look forward. Stretch the band, pushing your shoulders and elbows back. Hold for 5 seconds.

Perform:

• 10 repetitions
• 3 sets

Goals:

• Improve posture of the thoracic spine.
• Improve shoulder and scapula stability.

Protraction Exercise with Dumbbell:

Lying on your back, hold your arm perpendicular to the floor with a 2kg weight in your hand. Lift your shoulder off the floor and raise your arm. Hold for 5 seconds.

Perform:

• 10 repetitions
• 3 sets

Goals:

• Strengthening of the serratus anterior muscle.
• Improved scapular stability.
• Improved postural control of the shoulder and scapula.

Abduction Exercise with Elastic Band:

Standing. Use an elastic band, stepping on the foot on the side being exercised. Raise your arm without bending your elbow or wrist, without reaching parallel to the floor. Point your arm forward 30° as you raise it. Hold this position for 5 seconds.

Perform:

• 10 repetitions
• 3 sets

Goals:

• Strengthening the supraspinatus and middle deltoid muscles.
• Improve joint balance and shoulder stability.

External Rotation Exercise with Elastic Band:

Stand sideways to a door or structure that allows you to attach the resistance band. Hold the end with one hand. Place a towel between your chest and arm. Keep your elbow at 90 degrees, close to your chest, and your wrist straight. Keep your back straight. Gaze forward. Pull the band outward about 50 degrees. Hold for 5 seconds.

Perform:

• 10 reps
• 3 sets

Goals:

• Strengthen the shoulder's external rotators.
• Improve joint balance and shoulder stability.

Internal Rotation Exercise with Elastic Band:

Stand sideways to a door or structure that allows you to attach the resistance band. Hold the end with one hand. Place a towel between your chest and arm. Elbow at 90 degrees, close to your chest, and wrist straight. Back straight. Gaze forward. Pull the band inward about 50 degrees. Hold for 5 seconds.

Perform:

• 10 reps
• 3 sets

Goals:

• Strengthen internal rotators of the shoulder.
• Improve joint balance and shoulder stability.

External Rotation Exercise with Stick:

Stand. Grab a stick with both hands. Place a towel between your elbow and chest. Elbow at 90°. Push with your good arm and move the hand of the arm you're rehabilitating outward.

Perform:

• 10 reps
• 1 set

Goals:

• Pain relief.
• Improved anteroinferior capsular tension.
• Improved joint balance in external rotation.

Dumbbell Row Exercise:

Standing. Bend forward, letting your arm drop without exerting any force, so that it's perpendicular to the floor with a 2 kg dumbbell in your hand. Bend your elbow and bring it back. Hold for 5 seconds.

Perform:

• 10 repetitions
• 3 sets

Goals:

• Relief and prevention of shoulder pain.
• Improve shoulder and scapula stability.

Internal Rotation Exercise with Dumbbell:

 

Lying on your side on the shoulder you're rehabbing. With your elbow flexed at 90° and a dumbbell in your hand, bring the dumbbell toward your body. Hold for 5 seconds.

Perform:

• 10 repetitions
• 3 sets

Goals:

• Strengthening internal rotators.
• Relief and prevention of shoulder pain.
• Improve shoulder stability.

External Rotation Exercise with Dumbbell:

Lying on your side, place a towel between your arm and chest, elbow bent at 90°, and a dumbbell in your hand. Lift the dumbbell upward. Hold for 5 seconds.

Perform:

• 10 reps
• 3 sets

Goals:

• Strengthen external rotators.
• Relieve and prevent shoulder pain.
• Improve shoulder stability.

>> DOWNLOAD THESE EXERCISES FOR ADHESIVE CAPSULITIS HERE: Exercises-adhesive-capsulitis-drjordijimenez.PDF <<

>> DOWNLOAD A SHOULDER EXERCISE COMPLIANCE CALENDAR HERE: shoulder-compliance-calendar-drjordijimenez.PDF <<

Book an appointment with Dr. Jordi Jiménez. He will see you at the center of Palma de Mallorca and help you regain your quality of life.